MEDICARE: BEATRIZ VERA JACOBSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171R00000X	Interpreter

General Provider Information

NPI Number	:	1336398023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ VERA JACOBSON

Provider Business Mailing Address
First Line	:	1908 N MOHAWK ST
Second Line	:	SUITE #22
City	:	CHICAGO
State	:	IL
Zip	:	60614-5220
Country	:	US
Telephone Number	:	773-677-3758
Fax Number	:	312-787-3072

Provider Business Practice Location Address
First Line	:	1908 N MOHAWK ST
Second Line	:	SUITE #22
City	:	CHICAGO
State	:	IL
Zip	:	60614-5220
Country	:	US
Telephone Number	:	773-677-3758
Fax Number	:	312-787-3072

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	09/17/2008

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Directions to “ BEATRIZ VERA JACOBSON ” Practice Location

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